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首页> 外文期刊>African Journal of Biotechnology >Increasing trend of metronidazole resistance in the treatment of Helicobacter pylori infection: A global challenge
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Increasing trend of metronidazole resistance in the treatment of Helicobacter pylori infection: A global challenge

机译：甲硝唑耐药性在幽门螺杆菌感染治疗中的发展趋势：全球性挑战

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摘要

Helicobacter pylori?are gram negative spiral bacteria that colonize the human stomach. Infection with?H. pylori?is associated with chronic gastritis, peptic ulcer, gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue?(MALT)lymphoma. Antibiotic resistance is an ever increasing problem with the treatment of most microbial infections including?H. pylori; and has become a growing problem worldwide with the?eradication of this organism.?In recent years, several treatment regimens have been proposed for?H. pylori?eradication. However, the only conditions for which such treatment is strongly recommended on the basis of unequivocal supporting evidence are peptic ulcer disease and low grade gastric MALT lymphoma. Success of antimicrobial regimens for?H. pylori?eradication depends on patient compliance and lack of antimicrobial resistance. Metronidazole (Mtz) containing regimens have been shown to limit effectiveness because of increasing prevalence of resistance to this drug.??A high prevalence (> 90%) of Mtz resistance in?H.?pylori?has been reported especially in developing countries.?Mtz resistance may be mediated through an inability of Mtz-resistant strains to remove oxygen from the site of Mtz reduction, thereby preventing Mtz activation.? This has been attributed to a mutation on the?frxA?and/or?rdxA?genes resulting in strains of the organism with defective nitro-reductases coded by these genes.?Infection by Mtz or amoxicillin resistant strains is an important factor leading to treatment failure; subjecting all?H. pylori?clinical isolates to susceptibility testing most especially to Mtz is recommended. If not possible, a program to survey the prevalence of resistance should be implemented in a given area or population. This increasing emergence of antimicrobial resistance in?H. pylori?treatment posses serious public health problems and is therefore necessary that new drug regimens be examined.
机译：幽门螺杆菌是革兰氏阴性螺旋菌，定居于人的胃中。 H感染。幽门螺杆菌与慢性胃炎，消化性溃疡，胃腺癌和胃黏膜相关的淋巴样组织淋巴瘤（MALT）有关。对于大多数微生物感染（包括？H）的治疗，抗生素耐药性一直是一个日益严重的问题。幽门螺杆菌近年来，已经提出了几种针对H的治疗方案。幽门螺旋根除术。然而，根据明确的证据，强烈推荐此类治疗的唯一条件是消化性溃疡病和低度胃MALT淋巴瘤。 H抗菌方案的成功。幽门螺杆菌根除取决于患者的依从性和缺乏抗药性。由于对甲硝唑的耐药性增加，已显示出含有甲硝唑（Mtz）的方案会限制其有效性。据报道，尤其是在发展中国家，幽门螺杆菌对Mtz的耐药率很高（> 90％）。 ΔMtz抗性可以通过不能抵抗Mtz的菌株从Mtz还原位点除去氧来介导，从而阻止Mtz活化。这归因于“ frxA”和/或“ rdxA”基因的突变，导致该菌株带有由这些基因编码的有缺陷的硝基还原酶的菌株。Mtz或阿莫西林耐药菌株的感染是导致治疗的重要因素失败;服从所有？推荐对幽门螺杆菌临床分离株进行药敏试验，尤其是对Mtz。如果不可能，应该在给定的地区或人群中实施一项调查耐药性流行程度的计划。在？H中出现的抗菌素耐药性不断增加。幽门螺杆菌治疗带来严重的公共卫生问题，因此有必要对新药治疗方案进行检查。

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